A plurality of Americans want the Affordable Care Act repealed and replaced. The Republican Study Committee has worked on a replacement and come up with a proposal that has the support of a majority of House Republicans.


The plan combines all the old GOP ideas for health care in one package. Its major features are as follows. Specifically, H.R. 3121, the RSC's American Health Care Reform Act:

  • Fully repeals President Obama's health care law, eliminating billions in taxes and thousands of pages of unworkable regulations and mandates that are driving up health care costs. 
  • Spurs competition to lower health care costs by allowing Americans to purchase health insurance across state lines and enabling small businesses to pool together and get the same buying power as large corporations.
  • Reforms medical malpractice laws in a commonsense way that limits trial lawyer fees and non-economic damages while maintaining strong protections for patients.
  • Provides tax reform that allows families and individuals to deduct health care costs, just like companies, leveling the playing field and providing all Americans with a standard deduction for health insurance.
  • Expands access to Health Savings Accounts (HSAs), increasing the amount of pre-tax dollars individuals can deposit into portable savings accounts to be used for health care expenses.
  • Safeguards individuals with pre-existing conditions from being discriminated against purchasing health insurance by bolstering state-based high risk pools and extending HIPAA guaranteed availability protections.
  • Protects the unborn by ensuring no federal funding of abortions.

As might be expected, the emphasis here is on tax cuts in the form of actual deductions and in the form of Health Savings Accounts, which favor the rich. Smaller insurance companies in some states will be wiped out as the large insurance companies are allowed to come in. People with pre-existing conditions will be placed in high risk pools, guaranteeing them insurance coverage, but at much higher costs. Meanwhile all this competition will reduce costs in a business that is labor intensive and technologically sophisticated. Who wouldn't want their quadruple bypass performed by the surgeon who offers the lowest rates?

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No, what I am saying is that with the experience of the British and other national systems to guide us, we could craft a system much better than those we and they now have. It could lower the cost of healthcare by taking profit out of the equation and it could distribute benefits more equitably.

The problem we have now is that those with insurance get good care and those without insurance get only emergency care to the point of stabilization—for which we all pay in higher emergency and hospital costs.

The problem of underfunding would be a major obstacle to its working well and achieving its goals. At present the majority of people in the United States feel they are overtaxed even though income taxes are at historic lows. They are growing reluctant to pay for police, fire, and educational services so I doubt they are willing to pay for health services. People feel no connection to the country as a whole anymore and that's what you would need to put together a successful set of social programs.

No, what I am saying is that with the experience of the British and other national systems to guide us, we could craft a system much better than those we and they now have

But how?  Do you have any concrete ideas?  How do you suggest improving on the British single-payer system, since you think a single-payer system is a good idea? 

Why do you think a single-payer system would be better funded in the USA than in Britain?  People are no more willing to pay tons of money into the government here in the USA, so far as I know.  Perhaps less willing. 

Perhaps this shows instinctive good sense. 

As I said, the major problem with the British system has been consistent underfunding following a program of government austerity. The British system is not the only one from which we could draw ideas. The Scandinavian countries and France and Germany also have systems.

It seems the major impediments to a workable system in the US are politics and the need for every part of the system to make a profit. Cost ought not to be a problem since we now spend twice as much as any other country with worse results. The United States stands 15th among the nations in quality outcomes and 37th in overall efficiency.

Let me add that we now have a system of health insurance for the elderly that works reasonably well—Medicare. That should be the basic pattern for universal coverage with some changes.

One way to introduce universal single payer healthcare would be to extend Medicare to everyone with premiums included in income tax. The coverage could be etended downward from 65 in five year increments so that in ten years after passage everyone would be covered.

The one thing that Medicare needs to improve is its accounting, which is much too open to fraud.

Here's another problem:

In the UK they have a homeopathic hospital funded by the NHS, at least they used to.  Because a lot of people believe in magic.  So even people who don't believe in magic are forced to pay for it. 

Is it OK to have our forever financially-challenged government paying out money to homeopaths? 

The National Health System in the UK has supported homeopathic medicine over the objections of many of its physicians. Prince Charles and the incumbernt Secretary of State for Health, Jeremy Hunt, are supporters of homeopathy.

This is what happens when politics enters into the configuration of treatment. What treatments are allowed should be a decision based on the science, not politics.

In the US a strong support group for Chronic Fatigue Syndrome got money transferred to study it within the NIH budget a few years ago, against the recommendations of scientists.

@ Luara, Insurance of any kind is made from a pool of participants. Some are high risk. Their costs are offset by the low risk participants.
That's the way all insurance works. Whether it's health, home or auto insurance if you want more you pay for more but you can't have a top tier plan and leave out the basics. That's the way it works. I'd rather have not paid a huge premium for my daughter to be insured on my auto when she lived at home but because she was a young driver it's what I had to do to keep insurance. When her children become old enough to drive she will have to do the same.
It's for all of us but the way the health care system is the providers are able to take a massive portion for themselves. If the system was set up like medicare for every one it would remove the middle mans large portion and be cheaper all the way around.

I agree with you and k.h. ky here. If the GOP gets this it will just set things back like they were before with minimal changes and none of it helping the ones who need the help the most.
Want good health care. Model your system after the one used in France.
Now we have health care that protects the rights of the unborn? I'm sorry. If you are unborn you have no rights. You must become a person to have rights here. Oh, the sperm met the egg and instantly it was a person. What about miscarriage where the bloody mess is flushed down the toilet? How does god deal with that? Where are the "souls" of those persons? Maybe we will deal with that in another blog.

And it is estimated that many—perhaps half—of all zygotes never implant and the host doesn't ever know that.

You didn't have, Mindy. You had a simple miscarriage. These theist JO's believe that if the sperm met the egg you have an instant baby. How rediculous! If they really believe it why not get a coffin and retreive the matter and play "heavenly games" with it? Then everyone can cry coz the blood, sperm, and other matter "went to heaven."
I'm sick of it too.

Mandating that anyone buy full health insurance is a violation of people's right to lead their own lives without too much government interference.  Full health insurance has too much of an impact on people's personal lives to be dictated by the government. 

So I am in sympathy with the Republican position in that regard. 

I could understand it if there were a mandate to have catastrophic health insurance or - for really rich people - to be self-insured.  People need to have enough insurance provided for them somehow, that they won't be ruined by a car accident.  And enough that they don't need to use emergency rooms for routine care, and they can get decent care even if otherwise poor.

But Obamacare goes way beyond that. 

However, prohibiting insurance co's from discriminating on the basis of pre-existing conditions does seem like a good idea. 

So, like Republicans, you glossed over the part of the constitution where Congress is supposed to promote the general welfare.




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